SBC Communications Inc. workers will have to pick up a greater share of their health care expenses through increased copayments for drugs and office visits, under the new contract agreement reached late Monday.

Despite the concessions, union officials claimed victory for fending off the company's efforts to require workers to pay a portion of their health insurance premiums, and the company said the higher copayments will contribute to a nearly $2 billion savings over the five-year life of the contract.

While both sides reveled in the resolution, there's a growing sense that a similar scenario will be played out across the nation as labor negotiations, such as the contract talks for Northern California grocery clerks, continue to center on the issue of health care.

The trend is becoming predictable. A company tries to force more of the skyrocketing health care costs on its employees. Unions push back. Eventually, the two sides agree to a few more cost-sharing measures to resolve the immediate crisis. But the dynamics driving the increased premiums and the tension between employers and workers remain.

"The union workers are certainly in a better position to defend themselves than the rest of the workplace. But drug prices keep going up, and it's not going to be solved employer by employer, contract by contract," said Ellen Shaffer, director of the Center for Policy Analysis, a health research group in San Francisco. Shaffer advocates either universal health care on a national level or some form of relief by states.

The showdowns over health care costs also demonstrate that unions seem more willing to budge over salaries than health benefits.

Joanne Spetz, a health economist at UCSF, said part of the motivation behind favoring benefits over salaries may be that salaries, unlike health benefits, are taxed. In addition, she said, unions are anxious to demonstrate their value to workers as the strength of the labor movement has declined.

SBC officials said the company had to do something to trim its $3 billion health care tab. Its insurance premiums have been increasing by double digits since 2000, for an average of 14 percent, which is in line with national figures.

Under the contract, which is subject to approval by the Communication Workers of America, SBC workers will have higher copayments for visits to the emergency room and their doctors, as well as for prescription drugs.

Addie Brinkley, retiree board representative for CWA District 9, said she is comfortable with the copayments and their annual increases, which she said are more modest than originally proposed.

"Paying the (health insurance) premium is what our people did not want," said Brinkley, 67, of Modesto. "We knew we were going to pay something."

Office visit copayments, which previously ranged from $10 to $20, will rise to $20 for active workers and $25 for retirees in 2007. Emergency room copayments, now between $25 and $50, will reach $75 in 2008 for both current workers and retirees. A contribution of $40 per month will be required to cover a working spouse.

The changes in prescription copayments may be the most noticeable for most employees. Under the previous plan, medications cost around $6 for generic drugs and $15 for brand-name drugs, with some employees paying nothing for the benefit.

The new plan places the drugs in three categories: generics, preferred brand-name drugs and nonpreferred brand-name medications. In 2005, active employees will have to pay $5 for generics, $15 for preferred drugs and $25 for nonpreferred. Retirees will have to pay $10, $20 and $40, respectively, next year. By 2009, the price for brand-name drugs will increase to as much as $20 to $40 for active employees and $40 to $56 for retirees.

Requiring workers to pay an increasing portion of their health care costs is clearly a trend. According to a 2003 national survey by the Henry J. Kaiser Family Foundation, 96 percent of workers paid a copayment or a percentage of the cost for office visits; 76 percent paid part of their premiums and 92 percent paid a share of their family coverage.

When it comes to cost sharing for drugs, about 86 percent of workers in the companies surveyed had to pay different rates depending on the type of drug. In 2003, active workers paid an average of $9 for generics, $19 for preferred drugs and $29 for nonpreferred drugs.

A separate Kaiser Family Foundation survey of retirees showed they paid an average of $10, $20 and $35 for their drugs in 2003.

The SBC contract provides a $2,500 payment to retirees and a $1,000 payment to active employees to offset higher health costs.

"Achieving some cost savings in health care so we can be more cost competitive in this very, very competitive telecommunications environment is important to us, and we think we accomplished that," said SBC spokesman John Britton.

Union officials said resisting premium cost-sharing and receiving the lump-sum payments showed they didn't budge too much from their goal of preserving the health care benefits.

"We certainly acknowledge there's a serious health care crisis in this country, but the answer to that problem is not to just shift more costs to their workers year after year," said CWA spokeswoman Candice Johnson.